Introduction

As public health studies and news reports indicate, a pandemic, or worldwide outbreak of a new influenza virus, could overwhelm health and medical capabilities globally. This type of outbreak could potentially result in hundreds of thousands of deaths, millions of hospitalizations, and hundreds of billions of dollars in direct and indirect costs. This impact will likely be felt on the University of Maryland campus, as well as across the nation. This summary statement will provide an overview of the University of Maryland preparedness and response activities to mitigate campus-wide impact.

Pandemics occur when a novel virus emerges that infects and can be efficiently transmitted between humans. Animals are the most likely reservoir for these emerging viruses; avian viruses played a role in the last three influenza pandemics. The current pandemic threat stems from an unprecedented outbreak of avian influenza in Asia and Europe, caused by the H5N1 strain of the Influenza A virus.

While the H5N1 Avian Flu virus is not currently easily transmissible between people, the spread of earlier global pandemic influenzas and the outbreak of SARS in Asia during the 20th Century illustrate how large an impact the spread of infectious, and sometimes fatal, viruses can have on populations. The extremely high rate of mortality with the current H5N1 virus only serves to heighten the need for proper planning for the next new global pandemic. Should a highly contagious and highly fatal form of the H5N1 virus enter the global community, it may be only a matter of time before the virus enters the United States and sweeps through the Baltimore-Washington metropolitan area.

Consistent with Guidance for College and Universities found within the Implementation Plan for the National Strategy for Pandemic Influenza ("the National Plan"), the University plan addresses different outbreak scenarios including different levels of severity of the virus and rates of transmission. To prepare for the most severe health scenario to affect the campus communitythat of a highly infectious and fatal virus entering the United Stthe plan developed for the University is based upon the assumption that the campus may need to suspend the academic program and close the College Park campus for some number of weeks or months until the rate of transmission of the virus begins to reasonably subside. In this report, this period is referred to as a Temporary Campus Closure (TCC).

Given the ease in which seasonal viruses spread each year among the population, it is assumed that the academic environment of campus classrooms cannot be maintained in the face of this new global pandemic without putting students, staff and others at risk of infection and possibly worse. The National Plan and other health sources recommend taking steps toward social distancing, minimizing public assemblies, proper cough/sneeze etiquette, increased hand washing, and other actions, in order to slow, but never stop, the spread of the virus. Yet, it can be anticipated that at the height of a pandemic outbreak few students will feel comfortable sitting in classes without being fearful for their own health. In addition, the University may be directed by local, state or federal authorities to close the campus regardless of the institution's interest in doing otherwise.

The suspension of all classes and the closing of all residence halls will be potentially very disruptive for students wishing to attain Bachelors' degrees in four years or to complete graduate programs in a timely manner. Nevertheless, the UMD Avian Flu Pandemic Plan must contain such a scenario as a necessary means to protect members of the campus community.

The decision to close the University will be made by the Incident Response Team, chaired by President C. D. Mote, Jr. It will occur at a point after the first verified case is discovered in North America and be based upon a combination of the following decision criteria/factors:

•World Health Organization declaration of Phase 6Pandemic period: Increased and sustained transmission in the general U.S. population

•Confirmation of a high rate of infectivity, morbidity (rate of infection) and/or mortality (death rate) as identified by the Centers for Disease Control and Prevention's Pandemic Severity Index

•Rate/speed of disease spreading

•Local public health recommendations to curtail/cancel public activities in county or state

•Falling class attendance, students leaving campus

•Rising employee absenteeism

•Other regional schools/school systems closing

•Transportation systems closing/curtailing interstate travel

•Cases in the local Mid-Atlantic area occurring early versus late in the overall U.S. experience with the unfolding pandemic

During the period when classes are suspended, most campus academic, administrative, and support operations will be closed. Minimal utilities will be supplied to buildings, but all routine, normal daily housekeeping and maintenance activities will cease until such a time when the re-opening of campus buildings has been announced. Buildings will be secured in a way to prevent re-entry by all but approved essential staff. Most research activities that depend upon campus facilities will need to be suspended as well when all other routine building services end. Police, safety and facilities staff, and a small number of other essential employees will be needed to maintain safe, secure, and hazard-free buildings; however, the way in which these essential staff members conduct themselves while on campus will be done in a manner to minimize exposure to others who may be carrying the virus.

•The institution's response to the Avian Flu pandemic will be managed by the Incident Response Team (IRT). The IRT will incorporate part or all of the Avian Flu Task Force as needed throughout the pandemic period. It will meet weekly, daily, or more than daily as issues unfold. A location will be determined and expanded opportunities for conference call meetings have been established when large group meetings are no longer advisable or possible.

•Prior to the onset of the pandemic, officials will monitor the information available via the internet and other sources. Through all the stages of response, Dr. Sacared Bodison, Director of the University Health Center (UHC), will be the primary contact with the Maryland Department of Health and Mental Hygiene (DHMH), Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and the Prince George's County health officials. Kenneth Krouse, Director of Public Safety and Chief of Police, will maintain contact and coordinate with the local, state, and federal law enforcement agencies.

•An outbreak could interrupt normal University functioning for a period of two to four weeks up to several months.

•The University will implement social distancing measures and evacuate many of its students and employees, but it may need to maintain some systems to support continued infirmary operations, minimal student housing, and selected research activities.

•The University has existing communications resources that can be mobilized for quick response in the event of an Avian Flu emergency. Media relations and use of campus media outlets (1640 AM, WMUC, Terrapin TV) are additional assets to be used to support the communications plan.

•Essential employees may need to function from either remote or campus locations to maintain services. Options for limiting exposure of essential employees to the virus might be beneficial. Staff may be requested to work multiple shifts and critical staff may need to be on campus to service critical campus systems.

•Some level of loss of essential employees to illness or care for a loved one will require back up options for essential functions. Absenteeism attributable to illness, the need to care for ill family members, and fear of infection may reach 40% with lower but still significant absenteeism both before and after the peak (pandemicflu.gov). Also, absenteeism may be affected by the closing of public schools, quarantines, and other measures taken in the community.

•Those affiliated with the University, even if they are not employed or enrolled, will require information on the University's plans and implementation during the crisis. Parents and families, the surrounding community, governing bodies and elected officials will all require periodic updates.

•At all times, the health and safety of the campus community will be of paramount importance. Protocols for health and safety measures have been developed and are included in this document.

•This plan will apply to the initial outbreak, as well as subsequent waves of the Avian Flu Pandemic.

If a case of Avian Flu contracted by human-to-human transmission is identified anywhere in the world, the Incident Response Team will be activated. The regular membership of the team will be supplemented with individuals identified as providing leadership to the following areas of response: (1) Communications, (2) Academic Program, (3) Health and Safety, (4) Student Life, (5) Administrative Services, and (6) Transportation and Controlled Access. Each of these six areas of response is described here in more detail. Later in this report, these six areas are used to organize the response of the institution at each level of engagement with the potential flu pandemic.

1. CommunicationsCommunication will be maintained via the use of the web, e-mail, telephone, and the media, depending upon the continued availability of each of these options. Coordination of this area of response will be handled by Dr. Jeffrey Huskamp, the Assistant Vice President for University Marketing and Communications. Communication will be needed for various audiences at different stages of the pandemic. Specific plans for communication are outlined in the six Avian Flu phases in the following sections of this report. For each of these phases, draft communications will be developed in advance for use as needed.

WebThe recently developed Emergency Preparedness Website(http://www.umd.edu/emergencypreparedness), linked to the University's top level page, will be used for broadcast information of a general nature, including general campus status information, and specific Avian Flu information. As needed, the University Webpage will include links to other useful information. Updating can be done either on or off campus as conditions dictate. Two new applications are under consideration for development. A student locator service could be designed, with the same portal mechanism that allows parents to view student grades, to provide information to family members about their students including short date/time stamped messages. An additional application would enable faculty, staff, or students to post a date/time stamped message that can be viewed by the public and/or by members of the University community through use of a valid University e-mail account.

E-mailExisting mechanisms are in place for authorizing and sending mass e-mail (mega mail) to the campus community. As the situation develops, e-mail services for general use will be supported with essential staff and will include all faculty, staff, and student accounts as well as listserv services.

TelephoneUniversity land line telephones will be supported with essential staff and will include all current telephone lines. These telephones can be used to disseminate critical information to the campus via recorded voice mail messages. Cell phones may also be used for direct communication with critical employees as needed, depending upon continued service by such service providers.

MediaCritical messages may also be disseminated by Media Relations staff via newspaper advertising, commercial and public radio broadcast messages. The University may also utilize 1640 AM, the traffic radio station, to reach people coming to campus or in the immediate vicinity.

2. Academic ProgramContinuity of instruction and research will be coordinated by the Office of the Provost. These efforts will be directed by Provost Nariman Farvardin assisted by Dr. Robert Waters, Associate Vice President and Special Assistant to the President, and Dr. Phyllis Peres, Associate Provost for Academic Planning and Programs.

If and when the University closes for an extended time period due to Avian Flu, consideration will be given to the timing and duration of the closure. If the closure is less than two weeks, it will be assumed that the semester classes can be completed. If the closure is more than two weeks, the semester could need to be extended. If it is within four weeks of the end of the semester, the University would petition MHEC to accept grades at the point of closure. The goal, if at all possible, would be to recuperate the fall or spring academic semester. Alternate forms of instruction and contact (e.g., WebCT, blogs, podcasts, conference calls, etc.) will be pursued where feasible.

The University currently has an established refund policy on tuition, room, board, and fees. Any modifications to this policy would need to be determined based on decisions regarding length of closure, cancellation of classes/services, and granting of academic credit.

Modifications of the current refund schedule would require approval of the Cabinet, USM and/or the Board of Regents. It is likely that some coordination with the USM will be necessary on refund decisions.

During the closure period, access to the campus will be severely restricted for safety reasons and due to the absence of fully operational support systems. Most research activities that depend upon campus facilities will be temporarily suspended, with exceptions made for those having unique difficulty in closing. Examples might include labs where live animals are housed and failure to tend to them would cause significant loss of life.

3. Health and SafetyThe University Health Center, in conjunction with County and State health authorities, is responsible for coordinating all health care during a disease outbreak. Dr. Sacared Bodison, Director of the University Health Center, will provide leadership to those efforts. As needed, Residential Facilities will provide beds, and Conferences and Visitor Services will provide linen service for an infirmary. The Counseling Service, in conjunction with State mental health authorities (DHMH), following Red Cross approved disaster preparedness training, will suspend traditional counseling/psychotherapy and institute crisis intervention procedures (psychological first-aid) for campus victims of emotional trauma or post traumatic stress. First Responders are often prevalent among such victims. Dr. Vivian Boyd, Director of the Counseling Center, is responsible for coordinating all crisis intervention psychological services. Personal protective equipment (PPE) requirements and directions for use will be coordinated by Maureen Kotlas, Director of Environmental Safety.

4. Student LifeStudent housing will be maintained as long as classes are in session. Once classes are canceled, steps will be taken to close all University-owned and private-public residences. Temporary emergency shelter will be provided for a limited number of students who have difficulty leaving the campus (e.g., international students from countries impacted by the pandemic). Dr. Deborah Grandner, Director of Resident Life, and Michael Hayes, Director of Fraternity and Sorority Life, will coordinate. As long as residence halls are open, food service functions will be maintained, although modified. Dining Services will provide food service for staff and students in an infirmary facility. Colleen Wright-Riva, Director of Dining Services, will coordinate.

If an outbreak abroad endangers students or faculty in study abroad programs, the Office of International Education Services will respond to the situation, and will facilitate the evacuation of students, should it become necessary. Valerie Woolston, Director of International Education Services, and Dr. Michael Ulrich, Associate Director of International Education Services and Study Abroad, will get in contact with the entire faculty and staff affected abroad and will develop a response plan.

5. Administrative ServicesPolicies and procedures related to staff functions will be coordinated by the Office of Human Resources. Dale Anderson, Director of University Human Resources, will coordinate. Dr. Jack Baker, Director of Operations and Maintenance, will oversee Facilities Management issues and facility maintenance. The Office of the Comptroller is responsible for providing financial services. This includes processing and issuing employee pay checks, paying bills, and ensuring funds can be procured for any necessary outside vendors. Lynn Rehn, Comptroller, will coordinate.

6. Transportation and Controlled AccessThe Department of Transportation Services (DOTS) coordinates the University's efforts to move any people during disease outbreaks. David Allen, Director of Transportation Services, will coordinate. The University Police will be responsible for maintaining order. Kenneth Krouse, Chief of Police and Director of the Department of Public Safety, will coordinate.

As the disease progresses and becomes more widespread, the danger to the campus community will increase. The Avian Flu Task Force has organized its planning according to the following levels. The progression of these levels may occur rapidly and may be altered due to the recommendations of county, state, or federal authorities. A brief overview of these levels is provided here, with more detailed plans outlined in the sections of this report that follow.

Pre-Level 1: Prior to efficient human-to-human transmission

This phase of the Avian Flu plan begins at the present time and continues until there is a reported and substantiated first case of efficient human-to-human transmission somewhere in the world. It is a time for all communication plans to be finalized and academic units to complete plans for research interruption, alternative instruction, and class cancellation. Other administrative and student service units will finalize closure protocols, and order necessary supplies and plan for their distribution.

At Level 1, the Incident Response Team will begin to meet on a regular basis to fine-tune all plans for responding to the Avian Flu pandemic. All operations will continue as usual including classes and research, but more specific steps will be taken to prepare for Level 2. Communication with the campus community will increase to keep everyone informed of plans being implemented.

Level 2: (U.S. Government Response Stage 4) First verified case in North America AND one or
more other triggering events (listed below)

•World Health Organization declaration of Phase 6Pandemic period: Increased and sustained transmission in the general U.S. population

•Confirmation of a high rate of infectivity, morbidity (rate of infection) and/or mortality (death rate) as identified by the Centers for Disease Control and Prevention's Pandemic Severity Index

•Rate/speed of disease spreading

•Local public health recommendations to curtail/cancel public activities in county or state

•Falling class attendance, students leaving campus

•Rising employee absenteeism

•Other regional schools/school systems closing

•Transportation systems closing/curtailing interstate travel

•Cases in the local Mid-Atlantic area occurring early versus late in the overall U.S. experience with the unfolding pandemic

At Level 2, social distancing measures will be adopted including the cancellation of classes and all other activities. Health and Counseling Center staff will begin to implement emergency response procedures. Administrative departments, student service units, and all academic programs will begin the process of shutting down.

Level 3: (U.S. Government Response Stage 5 or confirmed local community outbreak) Within 1-5 days of declaring Level 2 and depending
on national and local conditionsAll University residences will close; thereafter
as soon as practicable most administrative offices and academic buildings will
close

At Level 3, all University residences will close. Dining operations will be reduced to support only the infirmary. All research operations, except those with critical facility needs (e.g., animal care) will be interrupted until the pandemic period has passed. All administrative and academic support units will be shut down until the campus reopens.

During Level 4, the campus will be closed. No vehicles or pedestrians will be permitted on campus unless approved as essential employees for tasks related to maintaining and securing the physical campus structure. All service contracts and construction projects will be put on hold.

Recovery Level: Recovery stage once pandemic is under controlCampus
poised to re-open.

Once the danger of the Avian Flu pandemic has passed, the campus will re-open for business. As services return to normal, accommodations for concerns that arose as part of the period of closure will be addressed.

These six levels of response (from Pre Level 1 through Recovery) provide the basis upon which the remainder of this report is organized. Each level is presented with specific actions that will occur in each of the identified areas of institutional response: (1) Communications, (2) Academic Program, (3) Health and Safety, (4) Student Life, (5) Administrative Services, and (6) Transportation and Controlled Access.